Outline

Background: Prefabricated septal buttons have the problem of movement within the perforation and thereby may widen it. Therefore, we used individual custom septal buttons made of silicone.

Material and Methods: From January 1, 1997 through June 30, 2004 57 patients were fitted with such a custom septal button. Follow up was 2.2 years on average. Patient satisfaction on different symptoms was scored on a visual analogue scale (VAS).

Results: 75% of patients had the septal button in situ at follow-up. These patients were extremely satisfied giving an overall improvement of 83% (std 20%) on VAS. All symptom scores improved significantly (p<0.05). We could not detect any increase in size of the defect. 14 buttons were removed on patients’ request after 0.5 years on average (1 day to 2.9 years) for the following reasons: intolerance 6, impaired nasal airway passage 3, pain 2, dislocation 2, asymptomatic fungal growth 1.

Conclusion: The failure rate is well within limits of the data from other studies. Not all patients are suitable for septal button treatment. However, this method provides highly satisfactory restoration of nasal function for most of the patients who are not candidates for surgical defect closure.